A midwife says the ACT's popular birth centre program is so in demand you almost need to "ovulate, copulate and get on the phone", favouring the territory's more privileged residents.
It comes amid suggestions of "turf" tensions among midwives and obstetricians in the ACT and beyond.
Giving evidence at an ACT Legislative Assembly inquiry into the territory's maternity system, Safe Motherhood For All policy officer Mary Kirk said the ACT should recentre its efforts towards midwife-led care for most mothers.
Ms Kirk - who is a midwife - said obstetric care was only necessary for about 15 per cent of mothers.
The Centenary Hospital for Women and Children offers a minimal intervention, midwife led care program throughout pregnancy for low risk women.
But places in the program are limited.
"To get into even the birth centre, you almost need to ovulate, copulate and get on the phone to get into the birth centre program," Ms Kirk said.
"It's limited by the capacity of the service and we know that there are many more that want the service than can have it, as well as the risk profile of who can go there and who can't.
"It was actually originally set up for the most vulnerable, for those people that struggle to feel comfortable in the regular system.
"Of course it drifted away from that to become for the very well informed and people with great capacity who can get in quickly and those most vulnerable were not the ones that could get in easily."
Ms Kirk advocated for the ACT to turn its maternity care on its head and make it the norm to have a midwifery model of care.
"I know there was a director that was very keen in the redevelopment of the current Centenary Hospital to turn the whole place into a labour delivery recovering unit and have midwifery model of care in the whole unit and a smaller space for the other care," she said.
"They couldn't get it through."
Ms Kirk said when obstetrics intervention was warranted it was "medicine at its best".
But she said it was "tripping into harm" when it came into spaces it wasn't needed.
When asked by opposition health spokeswoman Vicki Dunne about the "patch" tensions in the hospital's maternity units - often between midwives and doctors - she said it would be naive to say there was not politics at play.
"As far as I'm concerned, I don't care about medicine, I don't care about midwifery, all we need to do is put the woman in the centre," Ms Kirk said.
"If it's not best for the woman we can't got there."
The inquiry hearings will continue later this month, with the human rights commission and ACT government set to give evidence.